The symptoms of Parkinson's disease change as the
disease progresses. Because of this, your doctor will adjust your drugs to deal
with the symptoms as they appear.
Levodopa is the most commonly used drug for
Parkinson's disease. It works better than any other drug used to treat
Parkinson's disease symptoms and has fewer side effects. But after using
levodopa for over 5 years, many people start to have problems with
motor complications (times when the medicine suddenly stops working or when
you have uncontrollable jerking movements). Because of this, your doctor may
dopamine agonists such as pramipexole or ropinirole to
delay the point at which you need to begin taking levodopa. Studies have
suggested that this may delay the onset of levodopa's side effects.3 But in the longest study done, people who started treatment
with a dopamine agonist had just as many problems with motor fluctuations at 14
years as people who started treatment with levodopa.1
Your doctor may also prescribe levodopa along with a dopamine agonist.
Treatment when the condition gets worse
in the advanced stages of
Parkinson's disease is significantly limited in
movement and activity. Symptoms can change daily, and the side effects of drugs
can limit their effectiveness. Your doctor may change your drug in order to
deal with the symptoms as they arise.
A speech therapist can
suggest breathing and speech exercises that can help you overcome the soft,
imprecise speech and monotone voice that develop in advanced Parkinson's
disease. Changing how and what you eat can help you overcome problems with
eating. For example, sitting upright, taking small bites and sips, and eating
moist, soft foods can help you avoid nutrition problems and lessen your chance
of choking. Keeping your chin up, swallowing often, and not eating sugary foods
can help reduce drooling.
Freezing, or motor blocks, can be dealt
with through purposeful movement. Stepping toward a specific target on the
ground and making your first step a precise, long, marching-style stride can
help you overcome freezing episodes. A
physical therapist or
occupational therapist may be able to offer some
helpful advice to improve your walking and reduce your risk of falling.
Other common symptoms that appear during Parkinson's disease include
depression and sexual dysfunction. Talk to your doctor about ways to overcome
these problems. There are medicines that can help these symptoms in people with
You or your family members may notice that
you begin to have problems with memory, problem solving, learning, and other
mental functions. When these problems keep you from doing daily activities, it
dementia. There are medicines that can help treat
dementia in people with Parkinson's disease.
Surgeries such as
deep brain stimulation may be done during this
stage of the disease.